Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.16 / $19.67 / $19.67	Facility	26	$14.16	$19.67	$19.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.24 / $50.26 / $188.54	Professional		$29.24	$50.26	$188.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $12.94 / $53.00	Professional	26	$8.46	$12.94	$53.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.79 / $33.40 / $76.06	Professional	TC	$20.79	$33.40	$76.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.47 / $66.28 / $182.82	Professional		$30.47	$66.28	$182.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $21.11 / $58.81	Professional	26	$9.14	$21.11	$58.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.90 / $46.12 / $131.49	Professional	TC	$20.90	$46.12	$131.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.33 / $28.43 / $37.79	Facility	26	$24.33	$28.43	$37.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.13 / $117.91 / $133.99	Professional		$39.13	$117.91	$133.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.15 / $33.11 / $37.64	Professional	26	$11.15	$33.11	$37.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.09 / $84.83 / $96.40	Professional	TC	$28.09	$84.83	$96.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.01 / $81.73 / $217.42	Professional		$35.01	$81.73	$217.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.29 / $26.19 / $72.64	Professional	26	$11.29	$26.19	$72.64
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.52 / $56.40 / $199.00	Professional	TC	$23.52	$56.40	$199.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $33.89 / $74.33	Professional		$19.34	$33.89	$74.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $97.38 / $142.15	Professional		$65.00	$97.38	$142.15
Quartz Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.91 / $157.10 / $217.42	Professional		$52.91	$157.10	$217.42
Quartz Facility/Professional Professional Modifier 26 Low / Median / High Price $15.34 / $50.35 / $72.64	Professional	26	$15.34	$50.35	$72.64
Quartz Facility/Professional Professional Modifier TC Low / Median / High Price $36.53 / $106.75 / $199.00	Professional	TC	$36.53	$106.75	$199.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.20 / $191.11 / $210.12	Professional		$63.20	$191.11	$210.12
Security Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.42 / $28.37 / $53.36	Professional	26	$22.42	$28.37	$53.36
Security Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.78 / $57.12 / $125.05	Professional	TC	$40.78	$57.12	$125.05
United Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $73.78 / $157.22	Professional		$33.47	$73.78	$157.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $21.65 / $44.13	Professional	26	$10.47	$21.65	$44.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.73 / $50.13 / $93.57	Professional	TC	$22.73	$50.13	$93.57